Exergaming Compared to Conventional Physical Exercise Interventions on Health Status in Older People with Parkinson s Disease: A Systematic Review with Meta-Analysis of Randomized Controlled Trials

Background and Objectives: This systematic review aimed to analyze published peer-reviewed studies on the effects of exergaming (EXG) compared to conventional physical exercise (CPE) interventions on health status in older people with Parkinson s disease (PD) according to training dose. Materials and Methods: Using six generic databases: PubMed, EBSCO, Medline, CINAHL Complete, Scopus, and Web of Science, the PRISMA, TESTEX, RoB 2, and GRADE tools assessed methodological quality and certainty. The protocol was registered in PROSPERO (code: CRD42024575969). Results: Out of 805 records, 14 randomized controlled trials with 406 older people with PD were included. Seven overall meta-analyses showed significant improvements (p < 0.01) in favor of EXG in the Berg Balance Scale (BBS, ES = 0.90), Dynamic Gait Index (DGI, ES = 0.77) and quality of life questionnaire (PDQ-39, ES = 0.52), without significant improvements (p > 0.05) in the Unified PD Rating Scale, Montreal Cognitive Assessment, Timed Up-and-Go and Falls Efficacy Scale-International. Four subgroup meta-analyses, according to training schedules, showed that there were significant improvements (p < 0.05) in BBS in favor of EXG at >8 weeks of training (ES = 1.38), >3 weeks per week (ES = 1.18), <45 min duration (ES = 0.99), and with >20 total sessions (ES = 1.31). Both weeks and total sessions were predictors of BBS performance in EXG interventions in older people with PD. Conclusions: EXG is an innovative alternative to improve the health status in balance, gait, and quality of life variables in older people with PD, with a high potential for clinical practice in this population. The training dose is a determinant (weeks and total sessions) that varies the response to intervention in the BBS.